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BRCA Reconstruction

Introduction: Navigating BRCA Reconstruction & Risk-Reducing Mastectomy

A positive BRCA1 or BRCA2 mutation can feel overwhelming for you, and for every loved one who shares the journey. Questions about breast-cancer risk, the safety of a prophylactic (risk-reducing) mastectomy, and the best way to restore your sense of wholeness often arrive all at once. At East Coast Advanced Plastic Surgery (ECAPS), serving Montclair, Morristown, Hoboken, Ridgewood, Livingston, Pompton Plains, and Manhattan/NYC, we believe this pivotal moment calls for a combination of equal parts compassion and world-class surgical expertise.

Our priority is cancer-risk reduction. Working hand-in-hand with leading breast oncologic surgeons, we outline every surgical pathway from skin-sparing mastectomy to nipple-sparing mastectomy (NSM). Just as important is how you feel afterward. That’s why we offer a full spectrum of breast reconstruction options, including implant-based reconstruction, advanced DIEP tissue-based flap reconstruction, and innovative breast-lift (mastopexy) methods that preserve the nipple–areola complex when appropriate.

Whether you’re searching for the best BRCA breast surgeon team in the region or simply need a trusted guide to walk you through the decisions ahead, ECAPS is here to support, educate, and empower you every step of the way.

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What is BRCA?

BRCA 1 and BRCA 2 (short for BReast CAncer) are “guardian” genes that normally help repair everyday DNA damage. When someone inherits a harmful change in either gene, that repair system weakens, and the lifetime risk of breast (and some other) cancers increases. While BRCA mutations are the best-known, they’re not the only ones. Variants in genes such as PALB2, CHEK2, ATM, and TP53 can also raise breast-cancer risk above average.

If genetic testing shows you carry any of these high-risk variants, stronger screening or preventive options, such as skin-sparing or nipple-sparing mastectomy followed by reconstruction, can reduce cancer risk significantly. Our team partners with trusted breast oncologic surgeons and genetic counselors to guide you through every decision, ensuring you feel informed, protected, and supported from the very first consultation.

Your Reconstruction Roadmap

Implants, Tissue Flaps & Finding the Right Fit

Every successful BRCA-related breast reconstruction starts with a conversation. During your first visit, we’ll talk about your lifestyle, fitness goals, and feelings toward skin-sparing mastectomy versus nipple-sparing mastectomy. Those answers guide the surgical options that follow. From there, reconstruction falls into three main families:

Aesthetic flat closure

Some women choose to “go flat,” requesting a smooth, contoured chest without added volume. While studies show many patients gain psychological and emotional benefits from reconstruction, it isn’t the right fit for everyone. If a flat closure aligns with your goals, our team works with your breast surgeon to remove excess tissue and tailor the skin for a balanced, comfortable result.

Implant-based reconstruction

A silicone implant restores breast shape in one or two stages. It offers the shortest surgery and recovery time, making it an option for patients who do not have excess tissue for flap reconstruction.

Tissue-based reconstruction (DIEP flap)

Your own skin and fat create a warm, natural breast that changes with your body over time. Our signature approach is the DIEP flap, which transfers abdominal fat while fully preserving your core muscles—unlike older TRAM or “muscle-sparing” TRAM techniques. By teaming two microsurgeons on every case, we keep operating times safe, minimize blood loss, decrease microvascular complications, and consistently deliver excellent outcomes.

Some patients benefit from a hybrid plan that pairs a small implant with a flap or fat grafting for added softness and symmetry. Whatever route you choose, our plastic surgeons at ECAPS focus on maximum muscle preservation, minimal restrictions, and getting you back to an active, fulfilled life as quickly and confidently as possible.

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Restoring Sensation with Advanced Nerve Reinnervation

Beyond shape and symmetry, many patients worry about losing breast or nipple feeling after surgery. ECAPS is one of the few centers in the country that routinely performs sensory-nerve coaptation (Resensation) during DIEP-flap and implant reconstructions. This involves microsurgically reconnecting the tiny intercostal nerves to the nerve on the flap or preservable nipple-areola complex. Early data indicate that this technique can accelerate the return of warmth, softness, and a generalized sense of well-being, thereby adding another layer of emotional and psychological recovery to your outcome.

What Are the Benefits of a Prophylactic Reconstruction?

The benefits of BRCA reconstruction run much deeper:

  • Restores your body image after a prophylactic mastectomy
  • Reduces emotional distress by helping you feel whole again
  • Customizable results to suit your body type and preferences
  • Improved confidence in clothing, swimwear, and your day-to-day life
  • One-and-done or staged options, depending on your goals and lifestyle

And with today’s advanced surgical techniques, results are more natural-looking and long-lasting than ever before.

Who Are the Best Candidates For a Prophylactic Reconstruction?

If you’re BRCA-positive and considering a preventive mastectomy, you’re likely a strong candidate for reconstruction. You don’t have to wait until after a diagnosis to take proactive steps. Good candidates usually include:

  • Individuals with a confirmed BRCA1 or BRCA2 mutation, or other genetic variants increasing risk for breast cancer
  • Patients opting for prophylactic mastectomy
  • Non-smokers or those willing to quit prior to surgery
  • Healthy individuals without conditions that impair healing

What’s the First Step?

Schedule a consultation with our board-certified plastic-surgery team in New York City or New Jersey. During this one-on-one visit, we:

  • Listen to your goals and concerns
  • Review your genetic report, health history, and desired skin- or nipple-sparing mastectomy plan
  • Outline every reconstruction pathway (implant, DIEP flap, hybrid, or flat closure) so you understand the pros, cons, and timelines

There’s no pressure and no judgment, just clear information and expert guidance. By the time you leave, you’ll have a personalized roadmap and the confidence of knowing you’re partnered with a team of surgeons who put your long-term health, function, and peace of mind first.

What to Expect on the Day of BRCA Reconstruction Surgery

On the day of surgery, you’ll be greeted by our attentive medical team, prepped for anesthesia, and fully briefed on everything to expect. Depending on the type of reconstruction, the surgery length can vary. Implant-based reconstructions are typically shorter, while flap procedures, such as DIEPs, take a few hours longer, but utilize your own tissue for a more natural look and feel.

After surgery, you’ll be closely monitored in recovery. Some patients are discharged home the same day, while others may require an overnight stay for flap procedures. Our team makes sure you’re safe, comfortable, and fully supported every step of the way.

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BRCA Reconstruction Recovery

Recovery time can vary depending on the type of reconstruction you choose. Implant-based surgeries typically involve a shorter recovery period, with most patients returning to light activities within 2 to 3 weeks. Flap procedures, such as the DIEP flap, may require longer recovery times, typically returning to work in 6 weeks.

Expect some swelling, tightness, and fatigue in the early stages. You’ll likely wear a surgical bra to support healing, and if drains were placed, they’ll be removed within a week or two. Our team is meticulous with post-operative care, so you’ll receive detailed instructions and regular check-ins to ensure everything heals smoothly. Scar care is also part of your recovery journey, so we’ll guide you through treatments that help minimize visibility over time. 

How Much Does a BRCA Reconstruction Cost in New Jersey & New York City?

In most cases, prophylactic mastectomy and reconstruction for BRCA mutations are fully covered. Federal law requires insurers to cover breast reconstruction after mastectomy, including symmetry procedures and future revisions. That said, coverage details depend on your specific plan.

At ECAPS, we’ll verify everything for you upfront, walk you through any out-of-pocket costs, and make sure you have clear answers before moving forward. No surprises, no stress, just support.

Why Choose East Coast Advanced Plastic Surgery (ECAPS)?

With ECAPS, you’re not just choosing a practice—you’re choosing a team of specialists who live and breathe reconstructive excellence. Our board-certified, fellowship-trained plastic surgeons bring decades of experience, advanced training, and a truly compassionate touch. We perform hundreds of DIEP-flap, implant, hybrid, and nipple-sparing reconstructions each year, consistently achieving >99 % flap success rates while preserving core muscle function. As an early adopter of nerve-reinnervation (Resensation), we also lead the region in restoring sensation to the breast and nipple.

Just as important, we coordinate seamlessly with top breast-oncologic surgeons, giving you one clear roadmap from risk-reducing mastectomy through recovery. With offices in Montclair, Morristown, Hoboken, Ridgewood, Livingston, Pompton Plains, and Manhattan/NYC, plus telehealth and evening slots, world-class prophylactic reconstruction is always close to home and easy to access.

BRCA Reconstruction FAQ’S

Schedule a Consultation

We know this is a big decision, and it deserves a conversation that’s honest, supportive, and focused entirely on you. At ECAPS, scheduling a consultation means getting real answers, expert guidance, and a team that genuinely cares about your future. Whether you’re just starting to explore your options or ready to move forward with a surgical plan, we’re here for you. Use our online form or call one of our offices in New York and New Jersey to schedule your one-on-one appointment today. Let’s build something beautiful—together.

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